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A Vet's Review of Embrace Pet Insurance
2023
by Frances Wilkerson, DVM
This review discusses the 5 important pieces of coverage and payout structure
To get the most from this review, please read
the Guide to Pet Insurance
first.
For a detailed look at Embrace, see Embrace's Comparison Sheet.
Embrace has offered pet insurance since 2006. This review refers to Embrace's plans that have accident and illness coverage.
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In general, Embrace Pet Insurance covers examinations, diagnostics
and lab tests, surgery, treatments, prescription medication, and hospitalization
for eligible accidents/injuries and illnesses as long as the condition is not
pre-existing, has not occurred during the waiting period, and you
have not reached your maximum payout.
Dental coverage for accidents and illnesses is limited.
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Embrace Pet Insurance covers chronic diseases and provides continual coverage for chronic conditions as long as the condition is not
pre-existing, has not occurred during the waiting period, and you
have not reached your maximum payout.
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Hereditary, congenital, breed-specific and genetic conditions, including
hip dysplasia are covered by Embrace Pet Insurance as long as the condition is not
pre-existing, has not occurred during the waiting period, and you
have not reached your maximum payout.
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Embrace covers cancer conditions as long as the condition is not
pre-existing, has not occurred during the waiting period, and you
have not reached your maximum payout.
Osteosarcoma (bone cancer) falls under the 6 month waiting period for orthopedic conditions. Based on their website, this waiting period for orthopedic conditions may apply only to dogs.
(Contact Embrace to confirm)
According to their sample policy: "If a Pet has had Undiagnosed masses prior to the end of the Waiting Period, any mass, or condition where a mass is a Clinical Sign, is not covered, including those caused by cancer. If the cause of the mass that occurred prior to the end of the Waiting Period can be diagnostically narrowed down via cytology, un-related conditions may be covered."
Potential buyers of this policy need to understand that if their pet has a mass (tumor) anywhere in/on the body that is pre-existing or appears during the waiting period, they will need to get a diagnosis of that mass (paid for out of their own pocket) in order for unrelated tumors to possibly be covered after the waiting period. Also, not all masses can be diagnosed with cytology alone. Sometimes histopathology is needed which may be more expensive.
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Embrace covers breed specific medical conditions, as long as the condition is not
pre-existing, has not occurred during the waiting period, and you
have not reached your maximum payout.
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Embrace has an annual maximum
payout structure. They offer plans with a maximum annual payout of $5,000, $8,000, $10,000, $15,000, or $30,000. These choices of maximum payout will meet the needs of those whose calculated "Worst Case Scenario Costs" are $30,000 or less. Unlimited payout may be available in some states. (See: Picking
the Right Maximum Payout)
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Summary of Coverage and Payout Structure
Limitations
- According to their sample policy: "If a Pet has had Undiagnosed masses prior to the end of the Waiting Period, any mass, or condition where a mass is a Clinical Sign, is not covered, including those caused by cancer. If the cause of the mass that occurred prior to the end of the Waiting Period can be diagnostically narrowed down via cytology, un-related conditions may be covered."
Potential buyers of this policy need to understand that if their pet has a mass (tumor) anywhere in/on the body that is pre-existing or appears during the waiting period, they will need to get a diagnosis of that mass (paid for out of their own pocket) in order for unrelated tumors to possibly be covered after the waiting period. This information was deep within the sample policy. Also, not all masses can be diagnosed with cytology alone. Sometimes histopathology is needed which may be more expensive.
- 6 months waiting period for orthopedic conditions in dogs. Based on their website, this waiting period for orthopedic conditions may apply only to dogs.
(Contact Embrace to confirm) (Waiting Period may vary by state)
While the orthopedic waiting period can be waived with a healthy orthopedic exam completed within the first 30 days of policy period, please note that a Vet may want additional diagnostics (e.g. x-rays, ultrasound, etc) before they will feel comfortable certifying this. The cost of this will be out of your own pocket.
- Dental coverage for accidents and illness is limited
Good Points
- Strong underwriter
- Reimbursements are calculated by subtracting the deductible before applying the reimbursement percentage.
- Offers a variety of annual max payouts that will meet most people's
"Worst Case Scenario Costs"
- Provides comprehensive coverage in the 5 important areas as part of the base plan:
- Chronic disease
- Continual coverage for chronic disease
- Hereditary/congenital conditions
- Cancer
- Breed specific conditions
Concerns
- According to their sample policy: "If a Pet has had Undiagnosed masses prior to the end of the Waiting Period, any mass, or condition where a mass is a Clinical Sign, is not covered, including those caused by cancer. If the cause of the mass that occurred prior to the end of the Waiting Period can be diagnostically narrowed down via cytology, un-related conditions may be covered."
Potential buyers of this policy need to understand that if their pet has a mass (tumor) anywhere in/on the body that is pre-existing or appears during the waiting period, they will need to get a diagnosis of that mass (paid for out of their own pocket) in order for unrelated tumors to possibly be covered after the waiting period. This information was deep within the sample policy. Also, not all masses can be diagnosed with cytology alone. Sometimes histopathology is needed which may be more expensive.
Masses are very common in veterinary medicine. If a potential buyer misses this information and/or can't afford to get a diagnosis, they may end up with a policy that doesn't cover any malignant or non-malignant masses (tumors) after the waiting period.
- Their Bilateral Conditions policy is stated in their FAQ section on their website. The issue is that it doesn't clearly list the medical conditions that fall under this exclusion. There are so many body systems that inhabit both sides of the body (e.g. eyes, ears, knees, hips, front paws, elbows, toenails, kidneys, lungs, femur, etc). Not clearly defining which systems they are referring to leaves a big door open that could allow them to deem something as a bilateral exclusion whenever they see fit. Letting customers know what specific conditions and/or systems fall under this exclusion would be much more transparent. Even if they want the definition of Bilateral Conditions to include all body systems that inhabit both sides of the body, it is important that they clearly let the customer know this. Saying "not limited to..." just isn't enough.
- Based on their pre-existing conditions policy, signs and symptoms can be used to denote something as pre-existing. As with all pet insurance companies that use this wording, I have concerns that this can be used to deny claims even when these previous signs/symptoms are not directly related to the disease or condition currently in question.
Additional Comments Regarding All Pet Insurance Companies:
- Make sure you research what customers are saying about the company.
A company may have the 5 components that should be part of a pet insurance
plan, but the company may not be a hit with customers. Sites to check
include but are not limited to: BBB.org, Yelp.com and PetInsuranceReview.com.
Things to look for include but are not limited to: How fast are payments
paid?, What are customers saying about the pre-existing conditions policy?,
How often are claims denied and for what reason?, What is the customer
service experience like?, Are there issues with premium increases?
- Check with your state's Department of Insurance to see if any complaints have been filed for the company you are interested in.
- Make sure you understand what the waiting periods are.
- Make sure you understand their bilateral conditions policy.
- Make sure you understand any requirements that you must adhere to
to maintain coverage.
- Make sure you read the terms and conditions to get a thorough understanding
of all exclusions.
- Make sure you understand when and by how much your premium
can increase.
- If you change plan levels, there is a possibility that all medical
conditions present under the old plan will be considered pre-existing
in the new plan. Make sure you ask the company if this is the case.
- For some companies, pre-existing conditions can be based on signs and symptoms
alone, a diagnosis is not needed. For example, if your pet had a cough
before you applied for pet insurance and this cough was discussed and
written in the pet's medical record, there is the possibility that all
future cough conditions, no matter what the cause, would be considered
pre-existing - even if there was no treatment given. Make sure you ask
the company if this is the case.
- Pet insurance companies are businesses. The top priority of any business
is to make a profit for their stakeholders. Pet insurance companies
can and may change your rates and terms to meet that top priority. A
change of business ownership or underwriters can also be a catalyst
for changes in your rates and terms.
When you purchase pet insurance make sure you have a realistic understanding
of this and how it can affect you.
Additional Reviews:
24PetProtect | AKC | ASPCA | Bivvy | Companion Protect | Doggo
| Embrace | Fetch | Figo | Hartville | Healthy Paws | Lemonade | ManyPets | MetLife
| Nationwide | Odie | Petco | Pet Partners | Pets Best | Physicians Mutual | Prudent Pet | Pumpkin | Spot | Toto
| Trupanion | Wagmo
**Disclaimer: This review is meant to supplement, not replace your own due diligence. Terms and conditions can vary from state to state. Before buying a pet insurance plan, confirm all information by contacting the company or reading the most current policy for your state. We will not be held liable for errors or omissions. If you see something that is incorrect or needs clarifying, please let me know.
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